Congenital Heart Defects Flashcards
Patent Ductus Arteriosus
- Risk Factors
PDA RFs
- Prematurity (29 weeks)
- RDS
- Mechanical ventilation
- Infection
- Lack of antenatal steroid treatment
Patent DA
- Sequallae
- Pulmonary
- Systemic
PDA
- Sequallae
- Left to right shunt
- Increased pulmonary blood flow
- Respiratory distress
- Ventilator dependance
- Acidosis
- Pulmonary hemorrhage
- Chronic lung disease - Reduced systemic flow
- Hypotension
- Ischaemia (cerebral/mesenteric)
- Necrotising enterocolitis
- Intraventricular haemorrhage
CHD
- Physiological Fetal shunts
Fetal shunts
- Ductus arteriosus
- Ductus venosum
- Foramen ovale
CHD
- Genetic associations
CHD associations
- T21, T18, T13, 45 X0
- DiGeorge, CHILD syndrome
CHILD Syndrome
- Features
CHILD Syndrome
- Congenital hemidysplasia
- Ichthyosiform erythroderma
- Limb defects
ASD (cardiac)
- S&S
- Ix
- Mx
ASD
- S&S
1. Recurrent chest infections
2. Systolic (/mid-diastolic) murmur - Ix
1. ECG: RBBB
2. ECHO: Dilated RV - Secundum region defect
- Mx
1. Transcatheter closure
2. Surger
VSD
- S&S
- Mx
VSD
- S&S
1. SoB/Tach p/c
2. Failure to thrive
3. Tired even when eating - Mx
1. Self-resolving
2. Diuretics/ACEi/Calories
3. RSV Vaccination
4. <10% surgery
PDA
- Pres ( Pre-, Peri-, Post-)
- Mx
PDA
- Pres
1. 20 weeks antenatal scan
2. NIPE
3. Murmur
Mx
1. Transcatheter occlusion
2. Coil embolisation
AVSD
- Types
- S&S
AVSD
- Types
1. Partial - ASD and Single valve
2. Transitional
3. Complete - ASD, VSD, single valve
- S&S
1. Dependant upon size/position - ASD
- VSD
Aortic stenosis
- Presentation
- ECG
- Mx
Aortic Stenosis
- Presentation
1. Age variable - Baby very sick
- Child with murmur
- Older child with collapse
2. Ejection click
3. 45 X0 - ECG
1. T inversion
2. LAD
3. Tall precordial leads (Strain) - Mx
1. Monitor
2. Advise re: endocarditis
3. Balloon/open surgery
Co-arction
- Epidemiology
- Mx
Co-arction
- Pres
1. 10% of CHD
2. Neonate/teen - Mx
1. Neonate -surgery
2. Teen - balloon
Pulmonary Stenosis
- Pres
- Mx
Pulmonary stenosis
- Pres
1. Noonan syndrome - Mx
1. Balloon - If not supravalvular
2. Surgery
Cyanotic heart defects
- 5Ts + S
Cyanotic heart defects
- Tetralogy of Fallot
- Transposition of great arteries
- Tricuspid anomaly
- Ebstein’s - TAPVR
- Total anomalous pulmonary venous return - Truncus arteriosus
- Single ventricle
Tetralogy of Fallot
- Features
- Pres
- Mx
Tetralogy of fallot
- Features
1. VSD
2. Overriding aorta
3. Small PA
4. RVH - Pres
1. Loud systolic murmur
2. Single S2
3. RAD on ECG
Mx
1. PG1
2. Inotropes
3. Surgery
Cyanotic spell
1. Aetiology
2. Mx
Cyanotic spell
- Outflow obstruction
- Common in CHDs - Mx
- Flex hips
- Cut of femorals
Transposition of GAs
- Pres
- Mx
Transposition of GAs
- Pres
1. Antenatal scan - Parallel arteries
2. NIPE
3. Cyanosis D1-2
Mx
1. Balloon septostomy
2. Arterial switch op
Tricuspid anomaly
- Sequelae
- S&S
Tricuspid anomaly (Ebstein’s)
Sequelae
1. Displaced tricuspid
2. Small RV
3. Atrialised RV
- S&S
1. Cyanosis
2. Extreme RH failure
3. Adult arhythmia
TAPVR
- Pathology
- Obstructed
- Pres
- Mx - Unobstructed
- Pres
- Mx
Total anomalous pulmonary venous return
- Pathology
- Pulmonary veins return to RA not LA
- ASD must be present
- Obstructed
1. Neonate presentation - Pulmonary HTN
2. Emergency surgery - Unobstructed
1. Infant presentation - Chest infections
- Low sats
- Murmur
2. Surgery
Truncus arteriosus
- Pres
- Mx
Truncus arteriosus
- Common arterial trunk
Pres
1. Cyanosis after a few weeks
2. Mixed Ao and PA
Mx
1. Surgery
Single Ventricle Defect
- Pres
- Mx
Univentricular heart
- Pres
1. 5/100,000
2. Antenatal Dx - Mx
1. Palliation
2. Surgery - Norwood operation
- Glenn’s Surgery
- FONTAN Total CPC operation
